Pulmonary infection with the SARS-CoV2 virus can progress to acute respiratory distress syndrome (ARDS), in which inflammation and neutrophil hyperactivation play a central role. There is currently a lack of therapies for ARDS associated with COVID-19.
‘Beta blocker drug metoprolol might be effective in treating patients with severe COVID-19.’
Metoprolol is a well-established beta-blocker which has a highly selective effect on hyperactivated neutrophils during situations of acute stress such as a myocardial infarction or heart attack.
MADRID-COVID is a randomized clinical trial conducted in close collaboration between the CNIC and cardiology, ICU, pulmonology, and biobank services at FJD Hospital. This pilot trial examined the effect of intravenous metoprolol administration on lung inflammation and respiratory function in severe COVID-19 patients intubated after developing ARDS.
Randomized 20 intubated COVID-19 patients received intravenous metoprolol (15 mg per day over 3 days). later, they analyzed the inflammatory infiltrate in bronchoalveolar fluid before and after treatment and also monitored clinical progression parameters such as oxygenation and days on mechanical ventilation.
Co-author Eduardo Oliver, a Ramn y Cajal fellow at the CNIC, affirmed that the intravenous metroprolol treatment significantly reduced neutrophil infiltration of the lungs and improved oxygenation.
They also observed that metoprolol treatment in this clinical setting is safe, associated with a very significant reduction in lung infiltration, and appears to lead to very rapid improvements in patient oxygenation.
Researchers therefore proposed intravenous metoprolol as a promising intervention that could improve the prognosis of severely ill COVID-19 patients. They also emphasize that metoprolol is a safe and cheap drug (daily treatment cost below 2) that is readily available.
Although this was a pilot study and they need a larger trial to confirm about the safety, availability, and robust biological effect of metoprolol to use in young patients admitted to the ICU with severe COVID-19.
Source: Medindia
